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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by highanxiety on December 18, 2002, at 13:56:30
do they have any effectivenss on fight-or-flight physical symtpoms? how do they rate against beta-blockers? what about in combo? thanks again in advance for any responses.
Posted by Ritch on December 18, 2002, at 22:32:41
In reply to calcium channel blockers and anxiety??, posted by highanxiety on December 18, 2002, at 13:56:30
> do they have any effectivenss on fight-or-flight physical symtpoms? how do they rate against beta-blockers? what about in combo? thanks again in advance for any responses.
Well... Neurontin's mechanism involves some calcium-channel blockade and helps anxiety for many people (I had some success with it for that in the past-it seemed to make my environment non-threatening somehow). My pdoc has brought up verapamil (Calan, a CCB), a time or two, to add or substitute for hostility probs., and to possibly counteract hypertension from Wellbutrin or psychostimulants, and counteract diarrhea from SSRI's.
Posted by highanxiety on December 19, 2002, at 9:44:18
In reply to Re: calcium channel blockers and anxiety?? » highanxiety, posted by Ritch on December 18, 2002, at 22:32:41
thanks for the info. My new dr. a neuro, has decided to do neurontin and gradually "ramp up" to 1200 or 2400mgs a day, while i taper off the remeron. Thanks for your informative post, i'm glad to know that this drug will have some of these same qualities that will help with anxiety.
Posted by susan C on December 19, 2002, at 18:11:36
In reply to Re: calcium channel blockers and anxiety??, posted by highanxiety on December 19, 2002, at 9:44:18
Hi, I take vermapamil, a calcium channel blocker in addition to depakote and it has helped a lot. My blood pressure was not high, now is lower, as is my level of anxiety and overall am feeling more even and comfortable than I have in a long time. I understand it isn't a combination that works for everyone, however, it does work, and has few side effects.
mouse still crusing on route six six
Posted by Ritch on December 19, 2002, at 21:12:38
In reply to Re: calcium channel blockers and anxiety??, posted by susan C on December 19, 2002, at 18:11:36
> Hi, I take vermapamil, a calcium channel blocker in addition to depakote and it has helped a lot. My blood pressure was not high, now is lower, as is my level of anxiety and overall am feeling more even and comfortable than I have in a long time. I understand it isn't a combination that works for everyone, however, it does work, and has few side effects.
> mouse still crusing on route six six
Hi Susan! Yes, that is right-you were taking verapamil. So, does the verapamil seem to cause any *dulling*? That is what I am desperately trying to avoid. I know that some pdocs are using it off-label for hostility, hypomania, and anxiety, as well as treating drug-induced diarrhea, etc. I guess I am asking-if you are experiencing reduced anxiety are you getting any cognitive dysfunction as a result of the reduced anxiety?
Posted by susan C on December 20, 2002, at 11:29:32
In reply to Re: calcium channel blockers and anxiety?? » susan C, posted by Ritch on December 19, 2002, at 21:12:38
Hi, again Mitch;o)
Oh, how delightful to be able to write this response to your question: NO, ABSOLUTELY NOT, in fact, the COMPLETE OPPOSITE.(cut to scene with mouse in tu-tu exhuberently leaping about)
When I went to see the doc, within a month of beginning it, I sat down (I usually sit in his office) said a few words, and he interrupted me and said, YOU are Completely Different...your cognitive clarity has increased dramatically...
It could be, yes it could be just a coinsidence...that the illness is going through a remission, so to speak, but the timing is such, I think it is the CCB. There are other things I am observing that make me think this is the case also. If there are people who want to start a discussion on this, I will join in. So far, I have found few discussions on the use of CCB and Bipolar
In my case, I have tried many things, and it was on the list of things to try, and one with few unmanageable side effects.
As many people who have known me for a long time (like the receptionist at my dentist's) say, " it is so nice to have the old you back"
mouse bows
"Trying takes effort"
S.I. Clark
Posted by ZeeZee on December 20, 2002, at 14:04:40
In reply to calcium channel blockers and anxiety??, posted by highanxiety on December 18, 2002, at 13:56:30
This study shows a correlation between the use of Calcium Channel blockers and an increased incidence of depression and suicide. Beta blockers are effective for reducing the physical symptoms of anxiety however, they too run the risk of creating depression as a side effect.
http://www.pslgroup.com/dg/60296.htm
Posted by Ritch on December 20, 2002, at 19:22:48
In reply to Re: calcium channel blockers and anxiety??, posted by susan C on December 20, 2002, at 11:29:32
> Hi, again Mitch;o)
> Oh, how delightful to be able to write this response to your question: NO, ABSOLUTELY NOT, in fact, the COMPLETE OPPOSITE.
>
> (cut to scene with mouse in tu-tu exhuberently leaping about)
>
> When I went to see the doc, within a month of beginning it, I sat down (I usually sit in his office) said a few words, and he interrupted me and said, YOU are Completely Different...your cognitive clarity has increased dramatically...
>
> It could be, yes it could be just a coinsidence...that the illness is going through a remission, so to speak, but the timing is such, I think it is the CCB. There are other things I am observing that make me think this is the case also. If there are people who want to start a discussion on this, I will join in. So far, I have found few discussions on the use of CCB and Bipolar
>
> In my case, I have tried many things, and it was on the list of things to try, and one with few unmanageable side effects.
>
> As many people who have known me for a long time (like the receptionist at my dentist's) say, " it is so nice to have the old you back"
>
> mouse bows
>
> "Trying takes effort"
> S.I. Clark
Wow!, that is VERY interesting, to say the least. OK, Now I have got to ask the next question.... Are you *still* taking Depakote at the same dosage? IOW, is the verapamil the ONLY change that you made to your med regime? That is a very important caveat as we all know too well. Thinking aloud here, but when I was on small doses of Neurontin (with CCB activity), I was also more alert and focused (with low doses anyhow)-it also seemed to help with diarrhea predominant IBS symptoms, too.... I found about about verapamil from the grand rounds thing they do here and Eliot Gershon (sp?) was the one doing the presentation and I think he mentioned it as being used to treat diarrhea associated with lithium. Well.. I used to get horrendous diarrhea from lithium and, I am dose-limited on SSRI primarily due to that sfx, hypomania being 2nd to that. Anyhow, appreciate your response, happy Holidays, and could you answer my questions and tell me what meds/dosages you are on now? ::)Mitch
Posted by susan C on December 20, 2002, at 21:07:40
In reply to Re: calcium channel blockers and anxiety?? » susan C, posted by Ritch on December 20, 2002, at 19:22:48
hi, ok, here goes:
I have been taking the same amount of Depakote 500mg 2x day for almost two years. That amount did not change.In July,I stopped taking Ambien, because I was only sleeping 4 hours with it, this is in context of a long story of med trial....but I had stopped taking it before I started Verapamil. My sleep is acceptable now, better than when I first started using it. (another story)
I have contemplated that perhaps stopping Ambien lead to some improvement, but the time frame doesn't mesh.
I then started verapamil...in September and am now at 120mg am and 240mg pm
The ONLY other variable possible would be the hormones I had been trying to control hotflashes...but, in light of the previous trials, I am very familiar with what is and isnt working in that area, so I doubt it had anything to do with how I feel now. Simply, manipulating that component has never had any effect on my mental state.
Have I mentioned the constipation side effect with V? I seem to be effectively controling it with water, milk of magnegia or ground flax seed (good ol' fiber).
I hope this answers your questions...In general, I am very pedantic about med trials, I try to flush one before beginning another, doing one at a time, give each one a real chance before giving up. I REALLY want to know what works and why.
Mouse appreciating little blue pills
"Inquiry is evidence of a sound mind"
S.I. Clark
Posted by Ritch on December 21, 2002, at 8:46:24
In reply to a little bit of this and that » Ritch, posted by susan C on December 20, 2002, at 21:07:40
> hi, ok, here goes:
> I have been taking the same amount of Depakote 500mg 2x day for almost two years. That amount did not change.
>
> In July,I stopped taking Ambien, because I was only sleeping 4 hours with it, this is in context of a long story of med trial....but I had stopped taking it before I started Verapamil. My sleep is acceptable now, better than when I first started using it. (another story)
>
> I have contemplated that perhaps stopping Ambien lead to some improvement, but the time frame doesn't mesh.
>
> I then started verapamil...in September and am now at 120mg am and 240mg pm
>
> The ONLY other variable possible would be the hormones I had been trying to control hotflashes...but, in light of the previous trials, I am very familiar with what is and isnt working in that area, so I doubt it had anything to do with how I feel now. Simply, manipulating that component has never had any effect on my mental state.
>
> Have I mentioned the constipation side effect with V? I seem to be effectively controling it with water, milk of magnegia or ground flax seed (good ol' fiber).
>
> I hope this answers your questions...In general, I am very pedantic about med trials, I try to flush one before beginning another, doing one at a time, give each one a real chance before giving up. I REALLY want to know what works and why.
>
> Mouse appreciating little blue pills
>
> "Inquiry is evidence of a sound mind"
> S.I. ClarkSusan, thanks for the info. From reading your posts in the past I know you are vigilant with your med trials (I am mostly opposite-I document things fairly well, but I switch too quickly). I am looking at your Depakote dosage at 1G daily and my "spot" with it is 250mg daily. It seems that the "1/4 rule" seems to work out fairly reliably for me (dosage-wise on practically anything). I generally never needed more than 5mg/day of Prozac when I took that. 300mg of lithium worked about as well as 1200mg. 600mg of Neurontin probably worked as well for me as 2400mg does for many. So, you are taking 360mg total verapamil now, let's see that would likely be about 40mg twice daily for me to get similar effects (the lowest dose at the least often dosing schedule bid). I noticed your higher dosage at night. Does it make you drowsy (i.e. help your sleep)? Yes, I read your post about the constipation. That is rarely ever a problem that I run into. Do you have any problems with heart rate slowed excessively, or postural hypotension (dizziness)? thanks...Mitch
Posted by Ritch on December 21, 2002, at 8:51:12
In reply to See link to depression and suicide, posted by ZeeZee on December 20, 2002, at 14:04:40
> This study shows a correlation between the use of Calcium Channel blockers and an increased incidence of depression and suicide. Beta blockers are effective for reducing the physical symptoms of anxiety however, they too run the risk of creating depression as a side effect.
> http://www.pslgroup.com/dg/60296.htmThanks for the link. I couldn't get into BMJ to read the article, though. They didn't specify which CCB, just CCB's in general. My pdoc did mention that beta blockers were implicated with depression. There may be a strong dose relationship given that folks with severe cardiac disease would likely be on high doses.
Posted by ZeeZee on December 21, 2002, at 9:20:31
In reply to Re: See link to depression and suicide » ZeeZee, posted by Ritch on December 21, 2002, at 8:51:12
I do not suffer from depression but do anxiety/panic and agoraphobia. I've taken a quarter tablet of 50 mgs of a Beta Blocker (12.5 mgs)to lower my blood pressure and reduce all the internal nervous system discharge. It works great for a few weeks and then very slowly and insiduously my thinking begins to be bleak and dark and as well I become fatigued. It happens so slowly that I'm not even aware it's the drug causing the depression and fatigue. Once stopped the fatigue immediately stops as do the black thoughts. These side effects are not dose dependent and are much more likely to occur to those of us who have or are prone to mood disorders. I now take it only sporadically to soothe my insides so as to avoid the side effects and instead use another blood pressure med. on a regular basis.
I can't comment enough on how slowly this crept up on me. I suffered for too many months with this new found "depression" before realizing what was causing it. My physician (a very cool doc who also includes alternative medicine in his care) concurred.
Be careful and take care.
Posted by susan C on December 21, 2002, at 18:30:49
In reply to not dose dependent » Ritch, posted by ZeeZee on December 21, 2002, at 9:20:31
Hello ZZ
I have printed out your reference and plan to take it to my next appt. Thanks for the "heads Up"I am often frustrated by the lack of detail information in medical information. I will be the first to admit, a lot of the lack of clarity, comes from my lack of medical knowledge, so I try to stick to what I know, which is, how I feel. I try to keep things simple when I try medications, so I can point my finger accurately. One thing I have noticed for years is I can have the complete opposite effect promised by a medication, or I can have what I call the "2%" effect. Where they list on the paper side effects equal to or less than placebo...that is me. For example, I get suicidal ("emotional changes") from antihistamines and some kinds of antacids. Cripes!
One things for sure, we are all different. And I really appreciate there are people who specialize in this stuff.
mouse under the tree
"uncertainty is certain"
S.I. Clark
Posted by ZeeZee on December 21, 2002, at 20:25:07
In reply to Re: not dose dependent, posted by susan C on December 21, 2002, at 18:30:49
Yes me too! I always get the "rare to never" side effects. My experiences with SSRI's have been trips to hell and back (well almost back). I am still searching for the right medicine although my options seem to be very, very slim.
Good luck to you and take care.
Posted by highanxiety on December 21, 2002, at 21:05:25
In reply to not dose dependent » Ritch, posted by ZeeZee on December 21, 2002, at 9:20:31
Hi ZeeZee,
What is the medication that you take for your BP now that does not affect your mood? thanks...
Posted by ZeeZee on December 21, 2002, at 21:28:50
In reply to Re: not dose dependentZeeZee, posted by highanxiety on December 21, 2002, at 21:05:25
I take Micardis, 40 mgs twice a day. Norvasc, another blood pressure drug increased my anxiety, a documented s/e. I add a small dose of Toprol (beta blocker) on occassion.
This is the end of the thread.
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